Performance on rheumatoid arthritis quality indicators in an Alaska Native healthcare system

被引:11
作者
Ferucci, Elizabeth D. [1 ]
Donnithorne, Katherine J. [1 ]
Koller, Kathryn R. [1 ]
Swango-Wilson, Amy [1 ]
Pflaum, Jacqueline [1 ]
Lanier, Anne P. [1 ]
机构
[1] ANC HEP, Alaska Native Tribal Hlth Consortium, Anchorage, AK 99508 USA
来源
QUALITY & SAFETY IN HEALTH CARE | 2010年 / 19卷 / 05期
基金
美国医疗保健研究与质量局;
关键词
INDIANS; PATIENT; QUESTIONNAIRE; CRITERIA; SET;
D O I
10.1136/qshc.2008.030940
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Objective Rheumatoid arthritis (RA) is highly prevalent in some Alaska Native and American Indian populations. Quality indicators for RA have been proposed, but these have not been widely implemented or used to assess RA care in Alaska Native or American Indian populations. Methods Medical records were included if they met the following criteria: RA diagnosed before October 2000 fulfilling American College of Rheumatology classification criteria; all care for RA at the Alaska Native Medical Center. Records were reviewed for a 5-year period to determine compliance with eight quality indicators defined by the Arthritis Foundation Quality Indicator Program. Multivariate logistic regression was performed to analyse associations with quality of care. Results There were 106 individuals included in the study. The highest-scoring measures were folic acid prescription if on methotrexate (93.3%) and disease-modifying antirheumatic drug prescription (90.6%). The lowest scoring measure was radiographs of both hands and feet (16.0%). In multivariate analysis, the factor most strongly associated with disease-modifying antirheumatic drug prescriptions, annual exam for RA and hand radiographs was at least one visit with a rheumatologist. Conclusions Quality of care for RA varies by measure and is better for patients who see a rheumatologist. These data provide an initial evaluation of RA quality of care in a unique minority population with an integrated healthcare system.
引用
收藏
页码:387 / 391
页数:5
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